Erin Page

Size: px

Start display at page:

Download "Erin Page"

Spencer Barton
5 years ago
Views:

1 ACO ame and Location Accountable Care Coalition of orth Texas, LLC Loop Central Drive, Suite 700 Houston, Texas ACO Primary Contact Primary Contact ame Primary Contact Phone umber Erin Page Primary Contact Address Organizational Information ACO participants: ACO Participants ACO Participant in Joint Venture (Enter Y or ) Citimed, P.A. G. Suzanne Goodchild, DO, PA K-Care Family Medical PA Jamie Inman Ms Do Pa Cleburne Ob & Gyn Associates Dan Dinh guyen DO PA Rapha Medical Care, Pa Lake Granbury Internal Medicine & Pediatrics, Pa Dfw Family Clinic Jill Gramer DO PA Mount Moriah Family Medicine PLLC Angel's Star Wellness Center, P.A Tuan Dinh guyen DO PA

2 Quest Diagnostics Clinical Laboratories Inc Mesquite Regional Internal Medicine Fisher Cardiology and Electrophysiology Paul Bishop Kingsbrook Healthcare Services PLLC Metroplex Care Group Charles Smith Durbin Family Practice Pa Salam Al-Hafidh Md Facp Pa Stephen B Trammell DO PA Imre J Kocsis Basil Bernstein Md Pa Ralph T Wiegman Md Burleson Family Medical Center PA Michael Adamo Diamond Hill Medical Center PA R Greg Maul DO PA Dr. Richard J. Perry Do Pa Michael R. Mccullough, D.O., P.A. Rhodesia Lastrap Do Pa Clinical ephrology Associates PA Louis D Zegarelli DO PA Ronald A Stewart, D.O., P.A. Kaner Medical Group, PA Michael E Truman DO PA Israel A Hartman M D P A Roy L Caivano DO Anuradha L Mundluru MD John P Lavery MD PA Arlington Preventive Care Medical Clinic P A

3 orth Texas Lung & Sleep Clinic Pa Dr Carla Tabbs Md PA Acton Medical Clinic Pa C. Brooks Smtih M.D. & Associates Kanubhai A Patel Md Lake Country Family Medicine, P.A. Mansfield Medical Clinic ACO governing body: Member Member's Voting Power Membership Type ACO Participant TI Legal Business ame/dba, if Applicable Last ame First ame Title/Position Spain Jon Voting Member 18.75% Mundluru Anuradha Voting Member 18.75% Lavery John P. Voting Member 18.75% Patel Sneha Voting Member 18.75% ACO participant ACO participant ACO participant ACO participant Diamond Hill Medical Center, P.A. Mesquite Regional Internal Medicine John P Lavery MD PA Metroplex Care Group Morris Mary Voting Member 2% Medicare beneficiary Mesquite Regional Internal Medicine Holt Karen Voting Member 23% Other /A

4 Key ACO clinical and administrative leadership: Erin Page ACO Executive Karen Holt VP Operations Anuraha Mundluru Medical Director Michael Yount Compliance Officer Associated committees and committee leadership: Committee ame Committee Leader ame and Position Quality Improvement/Care Coordination Anuradha Mundluru, MD Types of ACO participants, or combinations of participants, that formed the ACO: etworks of individual practices of ACO professionals Shared Savings and Losses Amount of Shared Savings/Losses Second Agreement Period o Performance Year 2016, $2,591,659 First Agreement Period o Performance Year 2015, $2,181,324 o Performance Year 2014, $1,382,659 o Performance Year 2013, $0 Shared Savings Distribution Amount of Shared Savings/Losses Second Agreement Period o Performance Year 2016, $2,591,659 First Agreement Period o Performance Year 2015, $2,181,324 o Performance Year 2014, $1,382,659

5 o Performance Year 2013, $0 Shared Savings Distribution Second Agreement Period o Performance Year 2016 Proportion invested in infrastructure: 32% Proportion invested in redesigned care processes/resources: 37% Proportion of distribution to ACO participants: 32% First Agreement Period o Performance Year 2015 Proportion invested in infrastructure: 30% Proportion invested in redesigned care processes/resources 40% o Proportion of distribution to ACO participants: 30% o Performance Year 2014 Proportion invested in infrastructure: 0% Proportion invested in redesigned care processes/resources: 100% Proportion of distribution to ACO participants: 0% o Performance Year 2013 Proportion invested in infrastructure: /A Proportion invested in redesigned care processes/resources: /A Proportion of distribution to ACO participants: /A Quality Performance Results 2016 Quality Performance Results: ACO# Measure ame Rate ACO Mean 1 CAHPS: Getting Timely Care, Appointments, and Information CAHPS: How Well Your Providers Communicate CAHPS: Patients Rating of Provider

6 4 CAHPS: Access to Specialists CAHPS: Health Promotion and Education CAHPS: Shared Decision Making CAHPS: Health Status/Functional Status CAHPS: Stewardship of Patient Resources Risk Standardized, All Condition Readmission Skilled ursing Facility 30-day All-Cause Readmission measure (SFRM) All-Cause Unplanned Admissions for Patients with Diabetes All-Cause Unplanned Admissions for Patients with Heart Failure All-Cause Unplanned Admissions for Patients with Multiple Chronic Conditions Ambulatory Sensitive Condition Admissions: Chronic Obstructive Pulmonary Disease or Asthma in Older Adults (AHRQ Prevention Quality Indicator (PQI) #5) Ambulatory Sensitive Conditions Admissions: Heart Failure (AHRQ Prevention Quality Indicator (PQI) #8) Percent of PCPs who Successfully Meet Meaningful Use Requirements Documentation of Current Medications in the Medical Record Falls: Screening for Future Fall Risk Preventive Care and Screening: Influenza Immunization Pneumonia Vaccination Status for Older Adults Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention Preventive Care and Screening: Screening for Clinical Depression and Follow-up Plan Colorectal Cancer Screening Breast Cancer Screening

7 21 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented Statin therapy for the Prevention and Treatment of Cardiovascular Disease Diabetes Mellitus: Hemoglobin A1c Poor Control Diabetes: Eye Exam Hypertension (HT): Controlling High Blood Pressure Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - for patients with CAD and Diabetes or Left Ventricular Systolic Dysfunction (LVEF<40%) Please note, the 40 Depression Remission at 12 months quality measure is not included in public reporting due to low samples. For 2016 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/2016-Shared-Savings-Program-SSP-Accountable-Care- O/3jk5-q6dr/data For 2015 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/x8vaz7cu/data For 2014 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care-O/uccehhpu/data For 2013 Quality Performance Results please visit: Initiatives-Medicare-Shared-Savin/Medicare-Shared-Savings-Program-Accountable-Care- O/yuq5-65xt/data ote: In the Quality Performance Results file(s) above, search for Accountable Care Coalition of orth Texas, LLC. to view the quality performance results. This ACO can also be found by using the ACO ID A72294 in the public use files on data.cms.gov. Payment Rule Waivers o, our ACO does not use the SF 3-Day Rule Waiver.

8 Arrangements Disclosed REQUIRED PUBLIC DISCLOSURE FOR THE ACO PARTICIPATIO WAIVER The Accountable Care Coalition of orth Texas, LLC (the ACO ) participates in the Medicare Shared Savings Program ( MSSP ) under a contract with the Centers for Medicare & Medicaid Services ( CMS ). The Secretary of the Department of Health and Human Services has provided certain waivers of federal fraud and abuse laws in connection with the MSSP. On January 3, 2017, the Management Committee after previous discussions authorized, via unanimous written consent, an arrangement with Curant Health Georgia, LLC and Curant Health Florida, LLC (collectively Curant ) under which Curant will provide a grant of funds to assist the ACO s efforts with respect to the MSSP. Consistent with 42 CFR (b)(3), after discussing the proposed arrangement with Curant, the Management Committee made a bona fide determination that an arrangement with Curant as described below is reasonably related to the purpose of the MSSP and authorized such arrangement. The collaboration is related to the purposes of the MSSP as it augments the ACO s ability to: Promote evidence-based medicine and patient engagement; Meet the requirements for reporting quality and cost measures coordinating care; Establish clinical and administrative systems; Meet the clinical integration requirements of the Medicare Shared Savings Program; Evaluate the health needs of the ACO s aligned population; Communicate clinical knowledge and evidence based medicine to Medicare beneficiaries; and Develop standards for beneficiary access and communication, including beneficiary access to medical records.

9 Arrangements Disclosed REQUIRED PUBLIC DISCLOSURE FOR USE OF A ARRAGEMET ETERED ITO UDER THE ACO PARTICIPATIO WAIVER The Accountable Care Coalition of orth Texas, LLC (the ACO ) participates in the Medicare Shared Savings Program ( MSSP ) under a contract with the Centers for Medicare & Medicaid Services ( CMS ). The Secretary of the Department of Health and Human Services ( HHS ) by and through CMS and the Office of Inspector General, HHS has provided certain waivers of federal fraud and abuse laws deemed necessary by CMS to carry out the MSSP pursuant to the Final Waivers in Connection with the Shared Savings Program dated October 29, 2015, as may be amended, including a ACO Participation Waiver ( Participation Waiver ). On December 15, 2017, the Governing Body of the ACO after previous discussions authorized, via unanimous written consent, an arrangement with Laboratory Corporation of America Holdings ( LabCorp ) under which LabCorp will collaborate with ACO to provide ACO with laboratory data and test result values for ACO s assigned beneficiaries, and jointly develop an outreach program to ACO s providers/suppliers to provide educational services and information concerning. In addition to educational services, ACO will provide ACO providers/suppliers with, among other things, their applicable test result values and an analysis of such laboratory data so they can improve their patients care. Finally, LabCorp will provide a grant of funds to allow ACO to defray a portion of the costs to further develop and implement the program, including investment or modification of ACO s administrative and clinical systems, and otherwise assisting the ACO s efforts with respect to the MSSP. Consistent with the the requirements of the Participation Waivers, after discussing the proposed arrangement with LabCorp, the Management Committee of the ACO made a bona fide determination that an arrangement with LabCorp as described below is reasonably related to the purpose of the MSSP and authorized such arrangement. The collaboration is related to the purposes of the MSSP as it augments ACO s ability to: Promote evidence-based medicine and patient engagement; Meet the requirements for reporting quality and cost measures coordinating care; Establish clinical and administrative systems; Meet the clinical integration requirements of the MSSP; Evaluate the health needs of ACO s aligned population; Communicate clinical knowledge and evidence based medicine to Medicare beneficiaries; and Develop standards for beneficiary access and communication, including beneficiary access to medical records. Accordingly, ACO entered into this arrangement having determined that it meets all conditions to enable ACO to avail itself of the Participation Waiver.

ACO Name and Location ACO Primary Contact

ACO Name and Location ACO Primary Contact ACO ame and Location Chrysalis Medical Services, LLC 4888 Loop Central Drive Suite 700 Houston, Texas 77081 ACO Primary Contact Primary Contact ame Adrienne Opalka Primary Contact Phone umber 914-281-0827